Due to the varying size and location of the appendix and the proximity of other organs to the appendix, it may be difficult to differentiate appendicitis from other abdominal and pelvic diseases. Many older adults with appendicitis symptoms do not know that they have a serious problem until their appendix is close to rupturing. Diagnosis is based on patient history (symptoms) and physical examination backed by an elevation of neutrophilic white blood cells.
Ulceration of the appendix mucosa has been recendy reported as a major cause of the disease.The appendix is contained within the visceral peritoneum that forms the serosa, and its exterior layer is longitudinal and derived from the taenia coli. Sometimes an abscess forms around a burst appendix.

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